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Introduction. To investigate the effects of acupuncture on endogenous metabolites in the liver of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD) mice-based metabolomics. Methods. Proton nuclear magnetic resonance (1H-NMR) metabolomics combined with multivariate statistical analysis and univariate analysis were used to analyze the changes of endogenous metabolites in the liver of mice in each group and to provide new clinical ideas for acupuncture in the treatment of glycolipid metabolism disorders caused by T2DM and NAFLD. Results. After 4 weeks of continuous treatment, fasting blood glucose (FBG), insulin (INS), total cholesterol (TC), and triglyceride (TG) decreased significantly in mice in the acupuncture treatment group (ATG), and the content of liver glycogen increased significantly. Based on 1H-NMR metabolomic analysis, a total of 47 metabolites were identified in the liver of T2DM with NAFLD mice, of which eight metabolites: UDP-N-acetylglucosamine, adenosine, glutamate, isoleucine, ATP, 3-hydroxybutyric acid, NADP+, and leucine were significantly altered by acupuncture treatment. Through the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, it is found that acupuncture has an intervention effect on five metabolic pathways, mainly involving amino acid metabolism, energy metabolism, and oxidative stress. Conclusion. Our study shows that acupuncture can regulate the liver metabolism mode of T2DM in NAFLD mice. It can reduce blood glucose and lipid accumulation in the liver, and these findings provide a new idea and theoretical basis for acupuncture in the treatment of diseases related to glucose and lipid metabolism. [ABSTRACT FROM AUTHOR]

Acupuncture is a complementary therapy for diabetic peripheral neuropathy (DPN). This scoping review systematically collect clinical studies using acupuncture for the treatment of DPN to analyze and summarize acupuncture point prescriptions, treatment protocols, and outcome indicators regarding clinical trials of acupuncture for DPN. The results will help guide the selection of future clinical protocols. Eight databases were searched from their inception to March 1, 2023, including PubMed, Excerpt Medica Database (EMBASE), Web of Science, Cochrane Library, Google Scholar, China National Knowledge Infrastructure (CNKI), China Biology Medicine disk (CBM disk), Wan Fang, and Chinese Scientific Journal Database (VIP). Demographic characteristics of study participants, patients, treatment details, acupuncture prescriptions, and outcome indicators were screened and extracted. A total of 219 clinical studies were included, and the number of published studies showed a year-on-year increase. Two hundred eleven studies (96.34%) were conducted in China. One hundred fifty one (68.95%) were conducted in Traditional Chinese Medicine (TCM) hospitals. Two hundred and six (94.06%) studies were randomized controlled trials (RCTs) that treated patients with different clinical symptoms of DPN in 17,945 patients. The primary intervention was manual acupuncture treatment, most commonly with stainless steel needles (φ0.35 mm × 40 mm) left in place for more than 30 minutes. Acupuncture points SP6 and ST36 combined were applied most frequently, and the five points with frequencies over 100 were ST36, SP6, LI11, LI4, and GB34. The outcome indicators of acupuncture for DPN were mainly nerve conduction velocity, effectiveness rating scale, and efficiency. Adverse events were reported in only a few studies and mainly included nausea, pain, and diarrhea. This review provides evidence on treatment protocols, point prescriptions, and outcome metrics for acupuncture for DPN. However, the low quality of the study designs included in the clinical literature resulted in a degree of selection bias in the findings, which still needs to be validated by high-quality clinical trials. Future studies should be designed as more rigorous multicenter, large-sample randomized controlled trials to improve the accuracy and consistency of the effectiveness evaluation of acupuncture for DPN and enrich the standardized clinical treatment protocols for DPN. • Acupuncture may be an effective intervention for diabetic peripheral neuropathy(DPN). • ST36, SP6, LI11, LI4 and GB34 are the most commonly used acupoints for DPN. • Acupuncture is effective in improving nerve conduction velocity in DPN. • Manual acupuncture treatments last at least 30 minutes. • This scoping review may provide standardized treatment protocols. [ABSTRACT FROM AUTHOR]

Introduction: Traditional Chinese acupuncture has been demonstrated to be beneficial for treatment of type 2 diabetes mellitus (T2DM). The mechanism of acupuncture on T2DM is crucial for their biological activity as well as their usefulness as tools in biology and medicine. However, its mechanism is poorly understood. Methods: In an effort to explore the mechanism, eight db/db mice (a type of spontaneous T2DM mouse) were treated with adjusting internal organs and dredging channel electroacupuncture (AODCEA) for 2 weeks. Another eight db/db mice were fed as T2DM group (T2DMG), and eight db/m mice were set as normal control group (NCG). Lipopolysaccharide (LPS), interleukin-6 (IL-6), and diabetes-related indicators, such as fasting blood glucose (FBG) and triglyceride (TG), were detected by enzyme-linked immune sorbent assay (ELISA). The V4 region of 16S rRNA gene was analyzed by Illumina sequencing to evaluate the effect of AODCEA on intestinal flora. The amount of short-chain fatty acids (SCFAs) in the feces were determined by gas chromatography-mass spectrometry (GC-MS). Results: Our results indicate that AODCEA treatment can reduce diabetes-related indicators. We observed the increased probiotics such as Blautia and Lactobacillus and decreased opportunist pathogens (Alistipes, Helicobacter, Prevotella) by AODCEA interventions. Importantly, the total amount of SCFAs in the feces of T2DM mice was promoted by AODCEA. Finally, obviously alleviated systemic inflammation was exhibited through AODCEA treatment by detection of lipopolysaccharide (LPS) and interleukin-6 (IL-6) in serum. Conclusion: AODCEA can reshape the structure of intestinal flora, which can increase intestinal SCFAs, affect the circulating LPS level, and reduce the inflammatory response. [ABSTRACT FROM AUTHOR]

What is known and objective: To evaluate the clinical efficacy of acupuncture through a review and analysis of systematic reviews of acupuncture for the treatment of diabetic peripheral neuropathy. Methods: Systematic reviews of acupuncture treatment for diabetic peripheral neuropathy were collected by searching CNKI, VIP, Wanfang database, Chinese Biomedical Literature Database (CBM), PubMed, Web of Science and the Cochrane Library. The retrieval period was from the establishment of the database to February 14, 2020. After literature selection and extraction, included reports were evaluated in terms of the quality of the methodology and of the report using criteria from the AMSTAR2 scale and the PRISMA statement. Results and discussion: Eighty eight reviews were retrieved. The inclusion criteria were a published systematic evaluation/meta‐analysis/systematic review of acupuncture treatment for diabetic peripheral neuropathy, which included subjects meeting the diagnostic criteria for diabetic peripheral neuropathy, and which compared acupuncture treatment with non‐acupuncture treatment. After the inclusion criteria had been applied, 18 reviews were finally included. According to the PRISMA statement, 3 reports were relatively complete, 12 reports had certain defects, 3 reports had considerable information missing, and 18 reports had extremely low methodological quality according to the AMSTAR2 scale. Current evidence shows that acupuncture improves diabetic peripheral neuropathy and increases nerve conduction velocity. However, the methodological quality of the reviews is generally extremely low, and most of the reviews had certain defects, showing that there is still much room for improvement in terms of the methodology and quality of the research reports. What is new and conclusion: Acupuncture appears to have an effect on DPN, effectively improving nerve conduction and clinical symptoms. Although the methodological quality of the included studies was generally very low and defects were frequent, our study highlights areas where improvement in methodology is required. There is a need for further study of the pathogenesis of DPN, and for developing a unified standard for methods of acupuncture treatment, acupoint selection, and adverse reactions reporting. Traditional Chinese medical practices such as acupuncture should adopt an evidence‐based approach to provide greater confidence in their use. This review evaluates and verifies the efficacy of acupuncture in the treatment of diabetic peripheral neuropathy by using the quality of report and methodology, in order to provide reference for clinical decision‐making. [ABSTRACT FROM AUTHOR]